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426978 (BLCK)saysrvssw rcwnu. ti PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD - � . DST ',• 42697 8 COUNTY OF RIVERSIDE ( t CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ UNITS VOluaoti,��/,�' l r •� $ 2ND. FL. FOR. SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS CAR. P. SQ. FT. @ •�y WALL "\ SQ* FT. @ B r --� SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION' $' f Q ! 0 DRAINAGE PIPING DRINKING FOUNTAIN URINAL y WATER PIPING NOTE: Not to be used as property tax valuation. SWIM POOL, PVT FLOOR DRAIN MECHANICAL.FEES SWIM POOL, COMM WATER SOFTENER p, VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Type GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR' SUSPENDED Dbl $ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB Witness Fee $ SQ. FT. @ C WATER HEATER Owner/Agent SQ. FT. RESID @ 1 t/. c SEWAGE DISPOSAL - Zip SQ.' FT. GAR @ 3/. c HOUSE SEWER $ Addres,F .. - GAS PIPING PERMIT FEE + M.O. .C. t Cash n Check PERMIT TEE PERMIT FEE DBL. TOTAL FEEESS'y MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE F/CONST. /FEE /l ELECT. FEE SMI FEE FEE 1 PLUMB. FEE XXI PERMIT NO. 9 42 78 ' Job Address Spoc9 - L, 7o, -qe, i� Zip Owner T Z. Communitybs, i ( T i�"` VOluaoti,��/,�' l r •� $ Dote Dist.. F.C.C. MH.Permit Fee E Micro Film Fee CopIs Use of Permit x"✓ y.1 t r7 ���r ✓� Parcel No. -7 -1�' ��'^ D� CJ Use/Case No. Ck. By Mech. Fee Dbl $ PI. Ck. Fee s Set Backs Lot Size Construction Fee Dbl $ /0 Legal Description '�` } {r .pry' i ., r l� I 0 iig ` t i`� 4 1 Le-, V "� tiJ'* F S 5 R Electrical Fee Dbl $ Zone Restrictions ! G.,C,,, k �. } Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Pion Checker FinalDate In 'Dior Unit Sp. Insp. Fee $ fl Demol. Fee $ Const. Lender � • Branch Supplimental Permit Numbers Regisir. $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent n Tel. - - Zip Total Fees $ Addres,F .. - City _ YZip . �..._ + M.O. .C. t Cash n Check Received by AA ��gg - .r✓�++- Co 1r or . AddressZip [ .° t .I-t�`�....-- - + y _ 'G at j - M ' Tel.. '_ �• C1 Ci j License# / frees required Sewage System i�i� ('3 T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. r 1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN r Form 284-208 (Rev 8/78) ©s ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. , verified by: NO. OPERATION DATE INSPECTOR NO. OPERATION r LATE INSPECTOR BUILDING APPROV LS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms % 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel / b'J 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams a ®� 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T. 0. 0 P' ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 12B Ceiling (Batts) 12C Ceiling (Blown) 1 14 Final / PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L. Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL it ; t '. 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT q Effective July 1, 1980, Chapter 1301, Section 19825 of the Health and Safety Code requires the execu- tion -of the 'following applicable declarations prior to the issuance of.a building permit. Please print or type and sign below. 1V ^ LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full force and effect. License Class?; / — SC. i,3 License No. 386 908 Date Contractor TNS rg"�—I 'iC S7oc4-- OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: 0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. If I sell within one year of completion, I understand I will have the burden of proving I did not build or improve for the purpose of sale (Sec. 7031.5, B.&P.C.). [] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [� I am exempt under Section B.&P.C. for this reason: Date Owner Q� WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a Certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. Code).. Policy No. X f�LL1 / g S'V% Insurance t9/,t/O 0.417Ae c/4 Tisr 06 [� Certified copy is hereby furnished. ©' Certified copy is filed with the County of Riverside, Department off Building and Safety. Date '7/714/ Applicantcln..-, EJ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit valuation is for $100.00 or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California. I further understand that if after making this Certificate of Exemption, I should become subject to the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Date Applicant CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097; Civ. Code). Lender's Name Lender's Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION Q I hereby certify that no excavation five (5) or more feet in depth into which a person is re- quired to descend, will be made in connection with work authorized by this ;permit, and that no building, structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2,.Art 2, Sec 341, Title 8, C.A.C.) 0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such,person has a permit to do such work from that division. Q Division of Industrial Safety Permit No. Date Applicant CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to building construction, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon the pro- perty for which I have applied for this permit for the purpose of making inspections. gnature,of Applicant/Agent Date 17. orifi l/19�7 Bc�y ®.,i Pr n.t. pp c?at/ gent Name 284-2000 7/80 NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE // 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner f Z. Architect Contractor_%�,'C-SiG>rQ�+ —. _—_ �� •_jo.2� /�V J uQt�. Address_45��&0 Address Address___— ` City -/=o 1 City__— _ City_ Yk Phone 3a3 .. 8� 3� Phone _ Phone—.24z- S_ � z8 W I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and Z Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety 3 shall not make a Final Inspection until said requirements have been met. I am also aware that no work is to be done within the County R/W O without an encroachment permit. NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said p ty to be occupied until I (we) have said complied with all laws of the County of Riverside and the State of California governing said ty. DATE—d �.1____ SIGNATURE OF OWNER AND/OR AGENT. Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. 'J-- C-7 ISPACE NO. L/ 62 405"PA 1J7i/A_,,e1j6_Z/ USE OF ST UCTURE JOB ADDRESS ,, 2- - SINGLE FAMILY DUPLEX DESCRIPTION PROPERTY 2%CCT 'Z 0�Ov z F LEGAL OF , t �GO ��� Ste/ l - APARTMENTS AGRIC. ("�T "1 �l Q - --- '-' COMMERCIAL E] INDUSTRIAL n LA Ln >_ ONO. COMMUNITY . Li;WTQ ALTERATIONS n G Z�clC OF SUBMITTED PLANS — USE OF PERMIT rK ku Q w� LL, CASE NO. �- - - p Z NO. OF ARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING a -j ZONE SETBA(fKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE OF FEET REQUIRED ON STREET DATE -% -f -K SIGNATURE OF LAND USE OFFICIAL - DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET -- — t- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET t - a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O °C DATE _ SIGNATURE OF ROAD DEPT. OFFICIAI S SWIMMING POOLS PUBLIC t -I,_ SEWAGE DISPOSAL Q ~ _ FOOD ESTABLISHMENT WATER POLLUTION REMARKS 4A FLOOD CONTROL H W AIR POLLUTION 2 DIV OF HWY I 0 YOUR PROPERTY MAY BE SUBJECT TO — _ a c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT BUILDING PERMIT PERMIT NO. 426978 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD OFFICE CONSTRUCTION ESTIMATE Job Address w � � NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. Q SQ. FT. @ `P Communi Y //`\ 1 . t . _ , UNITS Valuation/ $ G/� _ oo SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ. FT. @ Cop $ POWER OUTLET ROOF DRAINS .CAR P. SQ. FT. @ WA SQ. FT. @ + ` �J 60 SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ 70 Use/Case No. DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation PI. Ck. Fee $ SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES Legal Description Tj +/) \ 1 0 \ (� 1\ �J�V SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD R SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Group Type GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Dbl $ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Inspect zip-, TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP $ POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. Address City SQ. FT. @ c BATH TUB Reinsp. Fee $ SQ. FT. @ t WATER HEATER SQ. FT. RESID @1'/.t SEWAGE DISPOSAL Total Fees $ SQ. FT. GAR @ 3/4 C HOUSE SEWER City Zip M.O. C. CashEl Check GAS PIPING PERMIT FEE Co o - I' Y..► PERMIT FEE PERMIT FEE DBL. TOTAL FEES `4)o. MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE /a.aa SMI FEE FEE PLUMB. FEE A PERMIT NO. 1426978J Job Address w � � � Space Zip _ � � Owner (.`� Communi Y //`\ 1 . t . _ , . Valuation/ $ G/� _ oo Date .- . �� Dist. 4 Off, F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit 0-- �(,_ J X .S� �"" ( !1 Parcel No. -71 -1- -, e.2 ✓` 01 Use/Case No. Ck. By Mech. Fee Dbl $ PI. Ck. Fee $ Set Backs I Lot Size DO Construction Fee Dbl $ Legal Description Tj +/) \ 1 0 \ (� 1\ �J�V t F 5 S R Electrical Fee Dbl E`! Zone Restrictions " ' Group Type SMI Fee E Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Final Date Inspect zip-, Unit I Sp. Insp. Fee $ Demo!. Fee $ Const. Lender Branch Supplimenlal Permit Numbers Regisir. Fee $ Mileage Fee $ Address City Zip rr Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Q Add re City Zip M.O. C. CashEl Check Received by Co o - I' Y..► - Tel, rl e1 Licensed _ 111G��JJ� Trees required Sewage System ,(1 t1iJ1 Address tZ� ve �� (� y Ciet tc Q Zip 0�\, tI( l ef7-!r7 T LL P Sewer District Form 284-208 (Rev.8/78) ©s THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.